Purchase this article with an account.
Thomas Bacon, Kenneth Fan, Manishi Desai; Reconciling EMR: Glaucoma Medication Regimens. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3700.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The electronic medical record (EMR) and its implementation through the Affordable Health Care Act and Meaningful Use criteria has added an additional layer of complexity to patient care. This study is to evaluate the consistency between the EMR medication reconciliation (med rec) and the physician note in documenting the glaucoma medication regimen. Also to analyze which regimen the patient adheres to when there is a discrepancy between the med rec and the physician note. Finally demographic and patient care variables are analyzed in relation to compliance.
A continuous retrospective chart review of three glaucoma physicians in a tertiary care center between 10/1/2014 and 11/15/2014. Inclusion criteria included glaucoma clinic patients, age >18, and documentation of a glaucoma medication regimen in the EMR med rec or most recent physician encounter note. Additional data fields included age, sex, total number of medications, and glaucoma regimen as stated by: EMR med rec, physician note, and patient.
200 individuals were reviewed, 83 male and 117 female (average age 62.8, std dev 11.41). Overall 134 (67%) patients had consistent documentation between the EMR med rec, physician note, and patient stated compliance. Comparison between the most recent physician encounter and EMR med rec showed consistency in 159 (79.5%) patients. When patients were not compliant they were most likely to follow neither physician plan nor med rec (16%), followed by the physician note (14.5%) and lastly the med rec (2.5%). No difference in compliance between males and females (p=0.426) was noted. When grouped by decade, the highest noncompliance (9%) was age 70-79 (p=0.075). When stratified by total number of medications being taken, 1-5 group had the best compliance (71.87%) patients, and 16-20 medications group had the worst compliance (61.9%) (p=0.0059).
This study revealed high consistency between the EMR and physician encounter when evaluating glaucoma medication regimens but left room for improvement in documentation. It also highlights that when patients were non compliant they did not correlate well with medication reconciliation or physician plan. As previously established in the literature, this study also verified that increasing number of medications correlates with decreased medication compliance. Age may factor into compliance although results were slightly outside significance, while the sex of the patient does not.
This PDF is available to Subscribers Only